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Journal of Cancer Research and Clinical Oncology

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Open Access 01-12-2016 | Review – Clinical Oncology

Endometrial sampling devices for early diagnosis of endometrial lesions

Authors: Jiang Du, Yaling Li, Shulan Lv, Qing Wang, Chao Sun, Xin Dong, Ming He, Qurat Ulain, Yongxing Yuan, Xiaoqian Tuo, Nasra Batchu, Qing Song, Qiling Li

Published in: Journal of Cancer Research and Clinical Oncology | Issue 12/2016

Abstract

Purpose

Endometrial carcinoma is the most common gynecologic malignancy in both developed and some developing countries. Unlike cervical cancer, for which there is routine screening, only patients symptomatic for endometrial carcinoma typically seek medical help for its diagnosis and treatment. Dilatation and curettage (D&C) has been the standard procedure for evaluating suspicious endometrial lesions. The discomfort and injury caused by the D&C procedure, however, restrict its use as a screening method for early diagnosis of endometrial lesions. High-risk endometrial cancer patients would benefit from an effective and low-cost screening test. In recent years, several endometrial devices have been developed and proposed as screening tools.

Methods

We have reviewed and evaluated the literature relating to the endometrial sampling devices in clinical use or clinical trials, with the goal of comparing devices and identifying the most appropriate ones for screening for endometrial lesions. Eligible literature was identified from systematic PubMed searches, and the relevant data were extracted. Comments, letters, unpublished data, conference proceedings, and case reports were excluded from our search. Seventy-four articles on endometrial sampling devices were obtained for this review.

Results

The main screening devices for endometrial carcinoma are aspiration devices (such as the Vabra aspirator), Pipelle, Tao Brush, and SAP-1 device. Among these devices, the Tao Brush is the most promising endometrial sampler for screening for endometrial lesions. However, its sampling insufficiency, cost, and unsuccessful insertion rate (20 % in nulliparous and 8 % in parous women) are problematic.

Conclusions

A more accurate and low-cost endometrial sampler, with improved specimen sufficiency and higher sensitivity for endometrial lesions, needs tobe developed and clinically verified.

Abdelazim IA, Aboelezz A, Abdulkareem AF (2013) Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding. J Turk Ger Gynecol Assoc 14(1):1–5CrossRefPubMedPubMedCentral

Antoni J, Folch E, Costa J, Foradada CM, Cayuela E, Combalia N, Rue M (1997) Comparison of cytospat and pipelle endometrial biopsy instruments. Eur J Obstet Gynecol Reprod Biol 72(1):57–61CrossRefPubMed

Batool T, Reginald PW, Hughes JH (1994) Outpatient Pipelle endometrial biopsy in the investigation of postmenopausal bleeding. Br J Obstet Gynaecol 101(6):545–546CrossRefPubMed

Ben-baruch G, Seidman DS, Schiff E, Moran O, Menczer J (1994) Outpatient endometrial sampling with the Pipelle curette. Gynecol Obstet Investig 37(4):260–262CrossRef

Bistoletti P, Hjerpe A (1993) Routine use of endometrial cytology in clinical-practice. Acta Cytol 37(6):867–870PubMed

Bray F, Loos AH, Oostindier M, Weiderpass E (2005) Geographic and temporal variations in cancer of the corpus uteri: incidence and mortality in pre- and postmenopausal women in Europe. Int J Cancer J Int du Cancer 117(1):123–131CrossRef

Broso P (1995) Cervico-vaginal and endometrial cytology in the screening for endometrial cancer. Minerva Ginecol 47(11):503–507PubMed

Bunyavejchevin S, Triratanachat S, Kankeow K, Limpaphayom KK (2001) Pipelle versus fractional curettage for the endometrial sampling in postmenopausal women. J Med Assoc Thail =Chotmaihet thangphaet 84(Suppl 1):S326–S330

Check JH, Chase JS, Nowroozi K, Wu CH, Chern R (1989) Clinical evaluation of the Pipelle endometrial suction curette for timed endometrial biopsies. J Reprod Med 34(3):218–220PubMed

Del Priore G, Williams R, Harbatkin CB, Wan LS, Mittal K, Yang GC (2001) Endometrial brush biopsy for the diagnosis of endometrial cancer. J Reprod Med 46(5):439–443PubMed

Demirkiran F, Yavuz E, Erenel H, Bese T, Arvas M, Sanioglu C (2012) Which is the best technique for endometrial sampling? Aspiration (pipelle) versus dilatation and curettage (D&C). Arch Gynecol Obstet 286(5):1277–1282CrossRefPubMed

Dijkhuizen FPHLJ, Mol BWJ, Brolmann HAM, Heintz APM (2000) The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia—a meta-analysis. Cancer 89(8):1765–1772CrossRefPubMed

Eddowes HA, Read MD, Codling BW (1990a) Pipelle: a more acceptable technique for outpatient endometrial biopsy. Br J Obstet Gynaecol 97(10):961–962CrossRefPubMed

Eddowes HA, Read MD, Codling BW (1990b) Pipelle—a more acceptable technique for outpatient endometrial biopsy. Brit J Obstet Gynaecol 97(10):961–962CrossRef

Elsandabesee D, Greenwood P (2005) The performance of Pipelle endometrial sampling in a dedicated postmenopausal bleeding clinic. J Obstet Gynaecol 25(1):32–34CrossRefPubMed

Fakhar S, Saeed G, Khan AH, Alam AY (2008) Validity of Pipelle endometrial sampling in patients with abnormal uterine bleeding. Annals of Saudi Med 28(3):188–191CrossRef

Foster-Rosales A, Koontz SL, de Perez OM, Leon K (2003) Cost savings of manual vacuum aspiration for endometrial sampling in El Salvador. Contraception 68(5):353–357CrossRefPubMed

Frishman G, Jacobs S (1990) A randomized clinical-trial comparing Pipelle and Tis-u-trap for endometrial biopsy. Obstet Gynecol 76(2):315–316PubMed

Fujihara A, Norimatsu Y, Kobayashi TK, Iwanari O, Nagaoka S (2006) Direct intrauterine sampling with Uterobrush: cell preparation by the “flicked” method. Diagn Cytopathol 34(7):486–490CrossRefPubMed

Gao J, Yang G, Wen W, Cai QY, Zheng W, Shu XO, Xiang YB (2015) Impact of known risk factors on endometrial cancer burden in Chinese women. Eur J Cancer Prev 25(4):329–334. doi:10.1097/CEJ.0000000000000178 CrossRef

Goldberg GL, Tsalacopoulos G, Davey DA (1982) A comparison of endometrial sampling with the Accurette and Vabra aspirator and uterine curettage. S Afr Med J 61(4):114–116PubMed

Guido RS, Kanbour-Shakir A, Rulin MC, Christopherson WA (1995) Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. J Reprod Med 40(8):553–555PubMed

Gungorduk K, Asicioglu O, Ertas IE, Ozdemir IA, Ulker MM, Yildirim G, Ataser G, Sanci M (2014) Comparison of the histopathological diagnoses of preoperative dilatation and curettage and Pipelle biopsy. Eur J Gynaecol Oncol 35(5):539–543PubMed

Hemalatha AN, Pai MR, Raghuveer CV (2006) Endometrial aspiration cytology in dysfunctional uterine bleeding. Indian J Pathol Microbiol 49(2):214–217PubMed

Iavazzo C, Vorgias G, Mastorakos G, Stefanatou G, Panoussi A, Alexiadou A, Plyta S, Lekka C, Kalinoglou N, Dertimas V et al (2011) Uterobrush method in the detection of endometrial pathology. Anticancer Res 31(10):3469–3474PubMed

Kaunitz AM, Masciello A, Ostrowski M, Rovira EZ (1988) Comparison of endometrial biopsy with the endometrial Pipelle and vabra aspirator. J Reprod Med 33(5):427–431PubMed

Kaur N, Chahal JS, Bandlish U, Kaul R, Mardi K, Kaur H (2014) Correlation between cytological and histopathological examination of the endometrium in abnormal uterine bleeding. J Cytol 31(3):144–148CrossRefPubMedPubMedCentral

Kawana K, Yamada M, Jimbo H, Shirai T, Takahashi M, Sano Y, Shiromizu K (2005) Diagnostic usefulness of endometrial aspiration cytology for endometrial cancer cases with normal curettage findings. Acta Cytol 49(5):507–512CrossRefPubMed

Kazandi M, Okmen F, Ergenoglu AM, Yeniel AO, Zeybek B, Zekioglu O, Ozdemir N (2012) Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling. J Obstet Gynaecol 32(8):790–794CrossRefPubMed

Kim MK, Seong SJ, Lee TS, Ki KD, Lim MC, Kim YH, Kim K, Joo WD (2015) Comparison of diagnostic accuracy between endometrial curettage and pipelle aspiration biopsy in patients treated with progestin for endometrial hyperplasia: a Korean Gynecologic Oncology Group Study (KGOG 2019). Jpn J Clin Oncol 45(10):980–982CrossRefPubMed

Kipp BR, Medeiros F, Campion MB, Distad TJ, Peterson LM, Keeney GL, Halling KC, Clayton AC (2008) Direct uterine sampling with the Tao brush sampler using a liquid-based preparation method for the detection of endometrial cancer and atypical hyperplasia: a feasibility study. Cancer 114(4):228–235CrossRefPubMed

Kitiyodom S (2015) The adequacy of endometrial sampling: comparison between manual vacuum aspiration and metal curettage method. J Med Assoc Thail =Chotmaihet thangphaet 98(6):523–527

Koonings PP, Moyer DL, Grimes DA (1990a) A randomized clinical-trial comparing Pipelle and tis-u-trap for endometrial biopsy—reply. Obstet Gynecol 76(2):316

Koonings PP, Moyer DL, Grimes DA (1990b) A randomized clinical-trial comparing Pipelle and tis-u-trap for endometrial biopsy. Obstet Gynecol 75(2):293–295PubMed

Kriseman MM (1982) Description of a new disposable uterine sampler (the Accurette) for endometrial cytology and histology. S Afr Med J 61(4):107–108PubMed

Leclair CM, Zia JK, Doom CM, Morgan TK, Edelman AB (2011) Pain experienced using two different methods of endometrial biopsy: a randomized controlled trial. Obstet Gynecol 117(3):636–641CrossRefPubMed

Leng X, Wang M, Zhang SL, Wang D, Cao W, Yang XH (2013) Different methods for the diagnosis of endometrial histological comparative study. Zhonghua fu chan ke za zhi 48(12):891–895PubMed

Leonardi M, Provenzale P, Zanardini L, Bellicini G (1993) The role of the Vabra aspirator in the screening of endometrial carcinoma. Our experience. Minerva Ginecol 45(9):395–398PubMed

Longacre TA, Chung MH, Jensen DN, Hendrickson MR (1995) Proposed criteria for the diagnosis of well-differentiated endometrial carcinoma. A diagnostic test for myoinvasion. Am J Surg Pathol 19(4):371–406CrossRefPubMed

Lubbers JA (1977) Diagnostic suction curettage without anesthesia an investigation into practical usefulness of vabra aspirator. Acta Obstet Gynecol Scand 62:1–12CrossRef

Machado F, Moreno J, Carazo M, Leon J, Fiol G, Serna R (2003) Accuracy of endometrial biopsy with the Cornier pipelle for diagnosis of endometrial cancer and atypical hyperplasia. Eur J Gynaecol Oncol 24(3–4):279–281PubMed

Maksem J, Sager F, Bender R (1997) Endometrial collection and interpretation using the Tao brush and the CytoRich fixative system: a feasibility study. Diagn Cytopathol 17(5):339–346CrossRefPubMed

Masukawa T (1981) Endometrial aspiration cytology in the diagnosis of hyperplasia and carcinoma. Acta Cytol 25(1):48

Moberger B, Nilsson S, Palmstierna S, Redvall L, Sternby N (1998) A multicenter study comparing two endometrial sampling devices—Medscand Endorette TM and Pipelle de Cornier R. Acta Obstet Gynecol Scand 77(7):764–769CrossRefPubMed

Morse AR, Ellice RM, Anderson MC, Beard RW (1982) Reliability of endometrial aspiration cytology in the assessment of endometrial status. Obstet Gynecol 59(4):513–518PubMed

Naim NM, Mahdy ZA, Ahmad S, Razi ZR (2007) The Vabra aspirator versus the Pipelle device for outpatient endometrial sampling. Aust N Z J Obstet Gynaecol 47(2):132–136CrossRefPubMed

Niklasson O, Johansson R, Stormby N (1981) Screening of endometrial carcinoma by jet wash and endo-uterine aspiration cytology. Acta Obstet Gynecol Scand 60(2):125–129PubMed

Polson DW, Morse A, Beard RW (1984) An alternative to the diagnostic dilatation and curettage–endometrial cytology. Br Med J 288(6422):981–983CrossRef

Poppendiek G, Bayer KH (1981) The cytology of endometrium by aspiration—a method for the early detection of endometrial carcinoma. Geburtsh Frauenheilk 41(3):188–191CrossRefPubMed

Rauf R, Shaheen A, Sadia S, Waqar F, Zafar S, Sultana S, Waseem S (2014) Outpatient endometrial biopsy with Pipelle versus diagnostic dilatation and curettage. J Ayub Med Coll Abbottabad 26(2):145–148PubMed

Roberts M, Rodgers AD, Johri S, Case BD (1994) Endometrial cytology—evaluation of samples obtained by outpatient aspiration. Brit J Obstet Gynaecol 101(7):628–629CrossRef

Rodriguez GC, Yaqub N, King ME (1993) A comparison of the Pipelle device and the Vabra aspirator as measured by endometrial denudation in hysterectomy specimens: the Pipelle device samples significantly less of the endometrial surface than the Vabra aspirator. Am J Obstet Gynecol 168(1 Pt 1):55–59CrossRefPubMed

Rosler EM, Wilken H, Beust M (1991a) Aspiration cytology—endometrial diagnosis in women with perimenopausal and postmenopausal bleedings. Zentralblatt Gynakol 113(19):1025–1032

Rosler EM, Wilken H, Beust M (1991b) Aspiration cytology–endometrium diagnosis of peri- and postmenopausal bleeding disorders. Zentralblatt Gynakol 113(19):1025–1032

Sanam M, Majid MM (2015) Comparison the diagnostic value of dilatation and curettage versus endometrial biopsy by Pipelle–a clinical trial. Asian Pac J Cancer Prev 16(12):4971–4975CrossRefPubMed

Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63(1):11–30CrossRefPubMed

Siegel R, Ma JM, Zou ZH, Jemal A (2014) Cancer Statistics, 2014. Ca-Cancer J Clin 64(1):9–29CrossRefPubMed

Sierecki AR, Gudipudi DK, Montemarano N, Del Priore G (2008) Comparison of endometrial aspiration biopsy techniques specimen adequacy. J Reprod Med 53(10):760–764PubMed

Smith K, Snyder RN, Willie S, Cove KJ (1980) Direct endometrial aspiration cytology—evaluation. Acta Cytol 24(1):75

Sundsbak HP, Jebsen P (1994) The Pipelle. A good instrument for histological endometrial diagnosis. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 114(3):317–318

Tabata T, Yamawaki T, Ida M, Nishimura K, Nose Y, Yabana T (2001) Clinical value of dilatation and curettage for abnormal uterine bleeding. Arch Gynecol Obstet 264(4):174–176CrossRefPubMed

Tajima M, Inamura M, Nakamura M, Sudo Y, Yamagishi K (1998) The accuracy of endometrial cytology in the diagnosis of endometrial adenocarcinoma. Cytopathology 9(6):369–380CrossRefPubMed

Tanriverdi HA, Barut A, Gun BD, Kaya E (2004) Is pipelle biopsy really adequate for diagnosing endometrial disease? Med Sci Monit 10(6):Cr271–Cr274PubMed

Tao LC (1997) Direct intrauterine sampling: the IUMC Endometrial Sampler. Diagn Cytopathol 17(2):153–159CrossRefPubMed

Tripathy SN, Mahanty J (1990) Place of aspiration cytology in dysfunctional uterine bleeding. J Indian Med Assoc 88(9):247–248PubMed

Van den Bosch T, Vandendael A, Wranz PA, Lombard CJ (1996) Endopap-versus Pipelle-sampling in the diagnosis of postmenopausal endometrial disease. Eur J Obstet Gynecol Reprod Biol 64(1):91–94CrossRefPubMed

van Hoeven KH, Zaman SS, Deger RB, Artymyshyn RL (1996) Efficacy of the Endo-pap sampler in detecting endometrial lesions. Acta Cytol 40(5):900–906CrossRefPubMed

Vuopala S, Klemi PJ, Maenpaa J, Salmi T, Makarainen L (1989) Endobrush sampling for endometrial cancer. Acta Obstet Gynecol Scand 68(4):345–350CrossRefPubMed

Wen J, Chen R, Zhao J, Dong Y, Yang X, Liao QP (2015) Combining endometrium sampling device and SurePath preparation to screen for endometrial carcinoma: a validation study. Chin Med J 128(5):648–653CrossRefPubMedPubMedCentral

Williams AR, Brechin S, Porter AJ, Warner P, Critchley HO (2008) Factors affecting adequacy of Pipelle and Tao Brush endometrial sampling. BJOG 115(8):1028–1036CrossRefPubMed

Wu HH, Harshbarger KE, Berner HW, Elsheikh TM (2000) Endometrial brush biopsy (Tao brush). Histologic diagnosis of 200 cases with complementary cytology: an accurate sampling technique for the detection of endometrial abnormalities. Am J Clin Pathol 114(3):412–418PubMed

Wu HHJ, Casto BD, Elsheikh TM (2003) Endometrial brush biopsy—an accurate outpatient method of detecting endometrial malignancy. J Reprod Med 48(1):41–45PubMed

Yang GCH, Wan LS (2000) Endometrial biopsy using the Tao Brush (R) method—a study of 50 women in a general gynecologic practice. J Reprod Med 45(2):109–114PubMed

Yanoh K, Norimatsu Y, Munakata S, Yamamoto T, Nakamura Y, Murata T, Kobayashi TK, Hirai Y (2014) Evaluation of endometrial cytology prepared with the Becton Dickinson SurePath method: a pilot study by the Osaki Study Group. Acta Cytol 58(2):153–161CrossRefPubMed

Youssif SNM, Mcmillan DL (1995) Outpatient endometrial biopsy—the Pipelle. Brit J Hosp Med 54(5):198–201

Zorlu CG, Cobanoglu O, Isik AZ, Kutluay L, Kuscu E (1994) Accuracy of pipelle endometrial sampling in endometrial carcinoma. Gynecol Obstet Investig 38(4):272–275CrossRef

Title: Endometrial sampling devices for early diagnosis of endometrial lesions
Authors: Jiang Du
Yaling Li
Shulan Lv
Qing Wang
Chao Sun
Xin Dong
Ming He
Qurat Ulain
Yongxing Yuan
Xiaoqian Tuo
Nasra Batchu
Qing Song
Qiling Li
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: Journal of Cancer Research and Clinical Oncology / Issue 12/2016
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-016-2215-3

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Endometrial sampling devices for early diagnosis of endometrial lesions

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